Kava is a drink made from the root of piper methysticum, a pepper plant native to the South Pacific.
It's a mild drug, the way coffee is---people drink it because it's fun.
Don't mix it with alcohol - immediate hangover.

What is it?

Kava is made by grinding the root into a powder and squeezing it in a bag with some lukewarm water. The result is a brown liquid, and it tastes earthy at best. You get it down in one gulp, if you can---that's the traditional way to drink it! In practice, you do this with all of your friends and family, and that's what makes it fun. The bad taste is part of the bonding experience.

What's its story?

The indigenous people of various South Pacific islands have used kava for at least 3,000 years, mostly recreationally (though Haiwaiians also use kava in some religious ceremonies). The so-called "noble" kava cultivars have been bred over the millenia for regular use. The kava you will generally find in the U.S. comes from Fiji or Vanuatu, and the East Bay's kava drinking culture inherits largely from the Fijian community.

What's the effect like?

The effect of kava is somewhere between caffeine, cannabis, and alcohol. Casual amounts are calming, disinhibiting, social, and a little bit psychedelic. It makes people more socially open, but doesn't affect their judgment or reasoning abiltiy. From Vincent Lebot et al., 1997:

When the mixture is not too strong, the subject attains a state of happy unconcern, well-being and contentment, free of physical or psychological excitement. At the beginning conversation comes in a gentle, easy flow and hearing and sight are honed, becoming able to perceive subtle shades of sound and vision. Kava soothes temperaments. The drinker never becomes angry, unpleasant, quarrelsome or noisy, as happens with alcohol. Both natives and whites consider kava as a means of easing moral discomfort. The drinker remains master of his conscience and reason.

Larger amounts are contemplative. From Gideon Lewis-Kraus, The New York Times (2019):

...In the late afternoon, a large museum crew would retire en masse to one of the many kava bars; kava, the national ritual drink, is a relaxing tonic of a cloudy green, which you drink from a miso-bowl "shell" in the solitude of a shadow. Unlike traditional bars, which tend to become louder and more volatile as people drink, kava bars tend to get quieter and calmer as the evening fades to black – until practically the only sounds are the screech of the native fruit bat.

Kava has many cultivars, which, like strains of cannabis, all have different effects. Some kavas are more "heady," like Waka. These will be more energizing, and are good for dancing and partying. Others are more "heavy," like Lawena. Those will help you sleep. With all varietals, higher doses push the psychedelic effect.

Is kava safe?

The World Health Organization (WHO) considers kava to have an "acceptably low level of health risk" (WHO, 2016). Like coffee, it will make you you need to pee, and may upset your stomach if you drink too much at one time. Heavy and long-term use (e.g., several gallons a day for months) can cause characteristic dry, flaky skin (known in Fiji as kanikani), which reverses when you stop drinking kava. In general, people have been drinking kava safely for thousands of years, and there's no evidence that moderate kava use has any negative health effects.

Kava and alcohol don't mix

As a recreational drink, kava is a great alternative to alcohol. However, kava and alcohol don't mix: kavalactones (the psychoactive chemicals in kava) inhibit some of the enzymes that help your body break down the toxic compounds in alcohol into a form your liver can process. When you drink kava alongside alcohol, you will feel the toxicity of alcohol much more strongly. You will get an immediate hangover, and you won't enjoy the effects of either kava or alcohol. If you don't believe me, try it: it's a mistake you'll only make once.

Having one beer two hours after one shell may not hurt you, but it's probably safest to avoid alcohol for the rest of the day after you drink kava.

Kava and cancer risk

Population-level observation studies associate kava use with a reduced cancer risk. From Bian et al (2020):

Nations with high kava consumptions, such as Vanuatu, Fiji and Western Samoa, have had much lower age-standardized cancer incidence rates in comparison to the rates in non-kava-drinking countries. Intriguingly, men in these regions had lower incidence rates of cancer than women, which is opposite to the general trends in other parts of the world; given that kava is mainly consumed by men, this observation is consistent with kava’s potential in reducing cancer risk.

Countries in which kava is popularly consumed tend have lower overall rates of alcohol consumption. Whether the lower observed incidence of cancers in kava drinking countries is fully explainable by, or in excess of, lower alcohol consumption has not, to my knowledge, been rigorously determined.

Kava and liver toxicity

In the 2000s, there were reports of hepatoxicity in Europe, associated with various "herbal supplements" that contained kava as an ingredient. (Several EU countries banned kava as a result of the hepatoxicity cases, though a few, like Germany, have since overturned those bans). No one knows exactly why those supplements caused those hepatoxic effects in Europe at that time, but researchers have settled on a few theories, none of which are mutually exclusive:

The extracts were made with alcohol, which could stress the liver (see: "Kava and alcohol don't mix," above.)
The extracts were made with aerial (non-root) parts of the kava plant, which are known to be hepatoxic.
The extracts were made of poor quality (non-noble, possibly even wild) kava
The extracts were adulterated with other herbs or substances.

It does not seem that drinking the traditional acqeous extract of kava is harmful to the liver, even among heavy users. From Balick & Lee (2002):

the Pohnpean dose is 8 times the recommended daily dose. If kava were toxic in its water-extracted form, we would expect to see an epidemic of hepatotoxicity in Pohnpei and other regions. However, this does not seem to be the case, based on my experience as a medical doctor in Micronesia, where kava is commonly consumed.

Is kava addictive?

Kava is not physically addictive. (Alcohol is; alcohol withdrawals can be deadly. Caffeine is also physically addictive; regular users get headaches or worse when they stop drinking caffeine). Nothing bad happens to your body when you stop drinking kava, no matter how much or how long you used it.

Of course, anything can be habit forming, and all addiction has behavioral and contextual components. Like with cannabis, plenty of people use kava more than they think they should. Whether that's likely to happen to you depends mostly on what your life is like, and what you're like with drugs. Personally, I have found that people who can self-regulate with substances can self-regulate with kava, though this is purely anecdotal.

For many people, drinking kava is in part a harm reduction strategy; it makes it easier to avoid drugs they'd rather not do, especially alcohol. Many people in addiction recovery drink kava, and many people who consider themselves sober drink kava and love it, much as many of those people use coffee or cannabis.

Where do I drink kava?

In the East Bay, Rootwater Kava Bar serves the best kava.

In San Bruno, Kava Bar San Bruno is Fijian-owned.

Go to other kava bars at your own risk. Some unscrupulous kava bars will also serve kratom, which is an unrelated and (for some) addictive drug that has no cultural or historical association with kava. Many kava bars will serve kava from the Soloman Islands, which is cheaper, but often lower quality. Most will not know much about kava. If you try a place out, ask what country the kava is from; if they don't know or can't answer, it's a bad sign.

elsehow/kava.md